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CM - Control > Practical 2 - Brainstem, Cranial Nerves and Cerebellum > Flashcards

Practical 2 - Brainstem, Cranial Nerves and Cerebellum Flashcards

1
Q

Which of the five major subdivisions of the brain make up the brainstem?

A

medulla oblongata

pons

midbrain

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2
Q

What type of information do the pyramids of medulla fibres carry?

A

descending motor fibres

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3
Q

where is the brainstem location of the gracile tubercle and fascicle?

A

dorsal surface of medulla

  • medial to cuneate
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4
Q

what is the general function of the gracile tubercle and fascicle?

A

contain first order sensory neurones (their terminations are the nuclei gracilis located in the gracile tubercle)

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5
Q

where is the brainstem location of the cuneate tubercle and cuneate fascicle?

A

dorsal surface of medulla

  • lateral to gracile
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6
Q

what is the general function of the cuneate tubercle and cuneate fascicle?

A

contain first order sensory neurones (their terminations are the nuclei cuneatus located in the cuneate tubercle)

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7
Q

where is the brainstem location of the cerebellar peduncles?

A

dorsal surface of pons

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8
Q

what is the general function of the cerebellar peduncles?

A

inf: connects medulla to cerebellum
middle: connects pons to cerebellum
sup: connects midbrain to cerebellum

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9
Q

where is the brainstem location of the inferior colliculus?

A

dorsal surface of midbrain

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10
Q

where is the brainstem location of the superior colliculus?

A

dorsal surface of midbrain

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11
Q

what is the general function of the superior colliculus?

A

associated with visual pathway

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12
Q

what is the general function of the inferior colliculus?

A

associated with visual pathway

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13
Q

what makes up the floor of the IVth ventricle?

A

Rhomboid fossa

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14
Q

what makes up the roof of the IVth ventricle?

A

superior cerebellar peduncle

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15
Q

What are the distinguishing features of the ventral surface of the medulla oblongata?

A

pyramids

olives

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16
Q

What are the distinguishing features of the ventral surface of the pons?

A

basilar (midline) groove

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17
Q

What are the distinguishing features of the ventral surface of the midbrain?

A

cerebral peduncle (basis pedunculi)

interpeduncular fossa

18
Q

which cranial nerves attach to the midbrain?

A

oculomotor (III)

trochlear (IV)

19
Q

which cranial nerves attach to the pons?

A

Trigeminal (V)
Abducens (VI)
Facial (VII)
Vestibulocochlear (VIII)

20
Q

What name is given to the angle between the medulla, the pons and the cerebellum, where the vestibulocochlear and facial nerves attach to the brainstem?

A

cerebellopontine angle

21
Q

which cranial nerves emerge at the cerebellopontine angle?

A

facial (VII)

vestibulocochlear (CN VIII)

22
Q

what is a acoustic neuroma?

A

a tumour that may develop on the vestibulocochlear nerve adjacent to its attachment to the brainstem

23
Q

Which cranial nerves are likely to be compressed if a acoustic neuroma tumour enlarges?

A

CNs likely to be compressed: CN VII; CN V; CN IX

24
Q

what are the signs and symptoms of an acoustic neuroma?

A

● CN VIII dysfunction (i.e. hearing loss and vestibular ataxia
—loss of balance and coordination)

● It may involve CN VII and CN V, resulting in facial palsy and trigeminal sensory loss.

25
Q

What is the method of testing the olfactory (I) nerve?

A

offer a familiar smelling item (orange/coffee)

26
Q

What is the method of testing the optic (II) nerve?

A

Visual acuity - snellen chart

colour vision - Ishihara plates

visual field - asking the patient to look directly at you whilst you wiggle one of
your fingers in each of the four quadrants.

visual reflexes - papillary response to light
- papillary accommodation: Advance finger in the
midline towards the eye and watch it move inwards. Pupils should constrict.

27
Q

What is the method of testing the oculomotor (III) nerve?

A

draw a large H with fingers

  • Follow finger test [look medially]
28
Q

What is the method of testing the trochlear (IV) nerve?

A

draw a large H with fingers

  • Follow finger test [look laterally]
29
Q

What is the method of testing the abducens (VI) nerve?

A

draw a large H with fingers

  • Follow finger test [look medially then downwards]
30
Q

What is the method of testing the trigeminal (V) nerve?

A

Sensory part:
- Cotton wool bud on forehead (Ophthalmic V1), cheek (Maxillary V2), jaw (Mandibular V3)
- Ophthalmic V1:
Corneal reflex test.

Motor part:Mandibular V3: Clench teeth and feel for muscle mass/jaw jerk reflex

31
Q

What is the method of testing the facial (VI) nerve?

A

Facial movements: asking the patient to raise their eyebrows, close their eyes and keep them closed against resistance, puff out their cheeks and reveal their teeth.

32
Q

What is the method of testing the vestibulocohlear (VIII) nerve?

A
  • ring’s and weber’s tests
33
Q

What is the method of testing the glossopharyngeal (IX) nerve?

A

gag reflex (by touching arches of the pharynx)

34
Q

What is the method of testing the vagus (X) nerve?

A

saying “aah”. Check that the uvula lies centrally and does not deviate on movement]

35
Q

What is the method of testing the accessory (XI) nerve?

A

Shrug shoulder and rotate head [against resistance]

36
Q

What is the method of testing the hypoglossal (XII) nerve?

A

stick tongue out

37
Q

What would you deduce if the tongue deviated to one side during protrusion?

A

➢ Deviation of the tongue is towards the same side of lesion

38
Q

which cranial nerves are involved in the pupillary light reflex?

A

CN II (afferent limb) and CN III (efferent limb)

39
Q

which cranial nerves are involved in the corneal reflex?

A

CN V1 (afferent limb) and CN VII (efferent limb)

40
Q

which cranial nerves are involved in the gag reflex?

A

​CN IX (afferent limb) and CN X (efferent limb)

41
Q

Which vessels provide the arterial supply to the cerebellum? Are they part of the anterior system of vessels to the brain or part of the posterior system?

A

➢ Cerebellar branches of the vertebral artery:

  • Superior Cerebellar Artery
  • Anterior Inferior Cerebellar Artery
  • Posterior Inferior Cerebellar Artery

➢ Part of the Posterior system of vessels

42
Q

what is a

Dysdiadochokinesis?

A

inability to execute rapidly alternating movements, particularly of the
limbs

CM - Control (20 decks)

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